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  • Management of Spinal Cord Tumors: Analysis of Resectability and Outcome

    Final Number:
    406

    Authors:
    Yunus Aydin; Halit Çavusoglu MD; Okan Kahyaoglu

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: In establishing the management for a spinal lesion, location is the most important feature, but the tumor extension and clinical presentation are also important. The goal of treatment is complete surgical resection while preserving neurological status and also spinal stability.

    Methods: Among 1334 patients with tumors of the spinal canal treated between 1994 and 2014, 313 patients with intradural tumors are presented. Most of tumors were extramedullar (59 %, n = 184) whereas 41 % (n = 129) were intramedullar. Patients underwent follow-up through outpatient visits and questionnaires with a mean follow-up of 48 ± 42 months.

    Results: The common intramedullary spinal cord tumors were astrocytoma, ependymoma, and hemangioblastoma. Gross-total resection rate was higher in cervically located intramedullary tumors compared to thoracic intramedullary tumors. Tumor extension did not influence on the resection rate. Cervical intramedullary tumors showed better postoperative functional outcome than thoracic intramedullary tumors. In intramedullary tumors extending more than 3 segments postoperative worsening was significantly increased. Most common extraamedullary spinal cord tumors were schwannomas, followed by meningiomas. A minimally invasive approach (unilateral hemilaminectomy) was used to remove the tumor, while preserving spinal stability. Perioperative permanent morbidity was very low.

    Conclusions: Spinal cord tumors should be surgically treated as soon as neurological symptoms appear. Patients with thoracic intramedullary tumors, and more than three segments tumors extension were at a higher risk for permanent morbidity. The minimally invasive approach allowed complete extraamedullary spinal cord tumors removal, and adequate preservation of vertebral stability, while providing a good postoperative course.

    Patient Care: These findings may help for decision-making process and treatment of these tumors.

    Learning Objectives: In establishing the management for a spinal lesion, location is the most important feature, but the tumor extension and clinical presentation are also important.

    References:

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